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Numbness, tingling, weakness, and pain in the thigh area

  : : My son, age 37 developed numbness, tingling, weakness, and pain in the thigh area of both legs beginning in May of 1997.  The symptoms are constant, varying from moderate to severe.  Walking as far as one city block can bring severe pain that lasts for several days.  He describes the pain as being similar to muscle fatigue after running a long distance.
  : : He has been to many different doctors including two neurologists and has had extensive blood tests, a muscle biopsy and an MRI.  The blood tests are in the normal range except for an elevated billirubin count (this has also shown up in earlier blood tests).  All other tests have failed to produce a diagnosis.
  : : He is in good health except for this problem.  I am suspect that he may have suffered nerve damage in the thigh area due to the fact that when the pain began, he was riding a stationary bicycle several miles a day.
  : : Can you suggest:
  : : 1. any course of action that we could take to diagnose and treat problem
  : : 2. any help in controlling the pain
  : : 3. any available information source.
  : : Any information or suggestions that you have will be greatly appreciated.  
  : ======================================================================
  : I will take your questions in reverse order.........
  : I do not think there are very many sources of information since you
  : do not have a diagnostic label to start with, so this makes searching
  : for information very difficult Other than sites like this on the internet
  : there is nowhere else to describe problems without a label.
  : A drug which is very effective in treating neuropathic  (or nerve derived)
  : pain is Neurontin . This is a new anti-epileptic agent, which is very free
  : of side effects and has been used with great success in peripheral nerve problems.
  : As regards testing you do not mention EMG, this is a very efective test in
  : identifying the existance, location and underlying pathiology in
  : peripheral nerve problems. I was surprised you did not mention it as being done already,
  : perhaps you forgot, if it has not been done I would suggest it be performed.
  : You do not say which part of his thighs are affected , if this is only on
  : the front it could be a form of meralgia parasthetica, a condition in
  : which a nerve is pinched in the groin area and can be released by a relatively
  : simple surgical procedure.
  Thank you for your quick response.
  To correct my earlier description of symptoms, there is no numbness and tingling.   The aching pain and weakness is throughout both legs.  Calf and thigh, front and back.  A needle EMG was done and did not produce any answers.
All of this new information gives his case a totally different character.
The possible cause which now comes to mind is that this may possibly be due
to a blood circulation problem ( claudication ) this causes achimg pain in
the legs on exertion which is eventually relieved by rest.
The investigation of this would required doppler ulrrasoung examination of
blood flow in his legs , probably soon after exertion. since you have had
extensive neurological investigations I think you should consider shifting
the focus to a possible blood supply problem. The relevant specialist would
be a vascular medicine specialist.

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